Finding into death of Sarah Louise Rose

40y · Female·Cerebral oedema of unknown aetiology with probable contribution from Hashimoto's encephalopathy (Steroid Responsive Encephalopathy Associated with Auto-immune Thyroiditis) in a woman with untreated Hashimoto's thyroiditis

Sarah Louise Rose, aged 40, died from cerebral oedema of unknown aetiology with probable contribution from Hashimoto's encephalopathy. She had been diagnosed with Hashimoto's thyroiditis in late 2011 and prescribed thyroxine, but likely ceased taking it months before her death. Over four months preceding death, she developed headaches, dizziness, confusion and altered consciousness. Despite two hospital admissions and extensive investigations, her Hashimoto's disease and medication non-adherence were not identified. The expert conclave agreed that optimal thyroid management by general practitioners, including reinforcement of daily thyroxine adherence and regular monitoring, would have improved her health. Similarly, hospital admissions provided opportunities for comprehensive history-taking that would have identified whether she was still taking thyroxine and allowed recommencement of therapy. However, the coroner found insufficient evidence to determine the primary antecedent cause to support adverse findings against treating clinicians.